Equipment Request Form

Name:

E-mail:

Date(s) and Time equipment is needed:

Location:

Equipment/Quantity Requested:

Cables
DVD Player	Qty
Projector	Qty
6 x 8 Screen	Qty
9 x 12 Screen	Qty

Will you require assistance with the set-up of equipment?

Please reference which payment method you will be using to pay the $50.00 rental fee in the comments/questions section. We accept cash, check, credit card or interuniversity transfer. No account numbers please. The VPC will contact you personally to obtain specific payment information.

Comments/Questions